不同术式治疗自发性气胸的对比研究

目的　比较前 /后外侧切口开胸、腋下小切口开胸和电视胸腔镜手术治疗自发性气胸的临床效果。方法　 89例自发性气胸患者接受外科治疗 ,其中 3 4例施行常规前 /后外侧切口开胸 ,3 1例行腋下小切口开胸 ,2 4例行电视胸腔镜手术治疗。对比各组切口长度、术中出血量及术后胸液量、哌替啶用量、拔管时间、住院天数等指标。结果　腋下小切口开胸组和电视胸腔镜组在上述指标等方面均明显优于常规开胸手术组 (P <0 .0 1) ,而腋下小切口开胸组和电视胸腔镜组之间无显著差别 (P >0 .0 5 )。结论　手术治疗自发性气胸疗效肯定 ,腋下小切口开胸术更经济、简单 ,符合现阶段多数病人的实际经济承受能力以及医疗安全和质量的需要 ,值得推广应用

Compare of the surgical ways of spontaneous pneumothorax

Objective compare the clinical results of antero/posterolateral thoracotomy (A/PLT),subaxillary minithoracotomy (SAMT) and video-assisted thoracic surgery (VATS) in treating spontaneous pneumothorax (SP).Methods Of the 89 patients with SP,34 were treated by APLT,31 by SAMT and 34 by VATS.The length of incision, the blood loss during operation,the dose of Dolantin used after operation, duration of the indwelling chest tube and hospital stay (days) were compared.Results These postoperative parameters in SAMT group and VATS group were superior significantly to those in APLT group (P<0.01),while there was no significant difference between SAMT group and VATS group(P>0.05).Conclusion The therapeutic results of SAMT are similar to those of VATS for treating SP.Both of them were more reliable and satisfactory than APLT.But the SAMT is worthy of being recommended in our country because of economy and simply.